中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2013年
5期
461-464
,共4页
薛尚才%李惠荣%范勇%王燕云%温玉%孙建玲%丁玲
薛尚纔%李惠榮%範勇%王燕雲%溫玉%孫建玲%丁玲
설상재%리혜영%범용%왕연운%온옥%손건령%정령
视网膜血管/病理生理学%荧光素血管造影术%糖尿病视网膜病变
視網膜血管/病理生理學%熒光素血管造影術%糖尿病視網膜病變
시망막혈관/병리생이학%형광소혈관조영술%당뇨병시망막병변
Retinal vessels/physiopathology%Fluorescein angiography%Diabetic retinopathy
目的 观察中心视网膜厚度对非增生型糖尿病视网膜病变(NPDR)眼底血管充盈状态的影响.方法 眼科及内分泌科住院治疗的无眼底病变的糖尿病患者及NPDR患者248例248只右眼纳入研究.所有患者均行光相干断层扫描(OCT)、荧光素眼底血管造影(FFA)、眼部彩色多普勒血液成像(CDFI)检查.排除中心视网膜有明显水肿、出血、渗出的其它眼底病变者.OCT测量距黄斑中心注视点1、1～3、3～6 mm处中心视网膜厚度,将患者按中心视网膜厚度分人视网膜厚度正常、变薄、增厚组.确定中心视网膜厚度正常范围为216.4～304.9 μm.中心视网膜厚度介于216.4～304.9 μm者纳入视网膜厚度正常组,＜216.4 μm者纳入视网膜厚度变薄组,＞304.9 μm者纳入视网膜厚度增厚组.FFA检查时,观察并记录臂-视网膜循环时间、视网膜动脉期-静脉期(A-V)荧光充盈时间.CDFI检查时,检测各组患者眼动脉(OA)、视网膜中央动脉(CRA)及睫状后短动脉(PCA)的收缩峰值速度(PSV)、搏动指数(PI)及阻力指数(RI).对比观察不同视网膜厚度组眼底血管充盈状态及眼部血流动力学指标异同.结果 视网膜厚度正常、变薄、增厚组患者的臂-视网膜循环时间分别为(10.42±0.51)、(10.36±0.64)、(12.94±0.46)s；视网膜A-V荧光充盈时间分别为(9.15±1.36)、(6.36±1.15)、(13.56±2.04)s.视网膜厚度增厚组与视网膜厚度正常组间(t=1.93,P=0.04)、视网膜厚度增厚组与视网膜厚度变薄组间(t=4.49,P=0.00)臂-视网膜循环时间比较,差异有统计学意义；视网膜厚度变薄组与视网膜厚度正常组间(t=2.13,P=0.03)、视网膜厚度增厚组与视网膜厚度正常组间(t=2.49,P=0.02)、视网膜厚度增厚组与视网膜厚度变薄组间(f=5.38,P=0.00)视网膜A-V荧光充盈时间比较,差异有统计学意义.视网膜厚度增厚组与视网膜厚度变薄组间OA、CRA、PCA的PSV(t=3.290、-5.520、-4.900)、PI(t=-4.310、-5.230、-4.390)、RI(t=4.970、6.160、5.990)比较,差异均有统计学意义(P＜0.05).结论 中心视网膜厚度对无眼底病变的糖尿病患者及NPDR患者眼底血管充盈状态有明显影响.
目的 觀察中心視網膜厚度對非增生型糖尿病視網膜病變(NPDR)眼底血管充盈狀態的影響.方法 眼科及內分泌科住院治療的無眼底病變的糖尿病患者及NPDR患者248例248隻右眼納入研究.所有患者均行光相榦斷層掃描(OCT)、熒光素眼底血管造影(FFA)、眼部綵色多普勒血液成像(CDFI)檢查.排除中心視網膜有明顯水腫、齣血、滲齣的其它眼底病變者.OCT測量距黃斑中心註視點1、1～3、3～6 mm處中心視網膜厚度,將患者按中心視網膜厚度分人視網膜厚度正常、變薄、增厚組.確定中心視網膜厚度正常範圍為216.4～304.9 μm.中心視網膜厚度介于216.4～304.9 μm者納入視網膜厚度正常組,＜216.4 μm者納入視網膜厚度變薄組,＞304.9 μm者納入視網膜厚度增厚組.FFA檢查時,觀察併記錄臂-視網膜循環時間、視網膜動脈期-靜脈期(A-V)熒光充盈時間.CDFI檢查時,檢測各組患者眼動脈(OA)、視網膜中央動脈(CRA)及睫狀後短動脈(PCA)的收縮峰值速度(PSV)、搏動指數(PI)及阻力指數(RI).對比觀察不同視網膜厚度組眼底血管充盈狀態及眼部血流動力學指標異同.結果 視網膜厚度正常、變薄、增厚組患者的臂-視網膜循環時間分彆為(10.42±0.51)、(10.36±0.64)、(12.94±0.46)s；視網膜A-V熒光充盈時間分彆為(9.15±1.36)、(6.36±1.15)、(13.56±2.04)s.視網膜厚度增厚組與視網膜厚度正常組間(t=1.93,P=0.04)、視網膜厚度增厚組與視網膜厚度變薄組間(t=4.49,P=0.00)臂-視網膜循環時間比較,差異有統計學意義；視網膜厚度變薄組與視網膜厚度正常組間(t=2.13,P=0.03)、視網膜厚度增厚組與視網膜厚度正常組間(t=2.49,P=0.02)、視網膜厚度增厚組與視網膜厚度變薄組間(f=5.38,P=0.00)視網膜A-V熒光充盈時間比較,差異有統計學意義.視網膜厚度增厚組與視網膜厚度變薄組間OA、CRA、PCA的PSV(t=3.290、-5.520、-4.900)、PI(t=-4.310、-5.230、-4.390)、RI(t=4.970、6.160、5.990)比較,差異均有統計學意義(P＜0.05).結論 中心視網膜厚度對無眼底病變的糖尿病患者及NPDR患者眼底血管充盈狀態有明顯影響.
목적 관찰중심시망막후도대비증생형당뇨병시망막병변(NPDR)안저혈관충영상태적영향.방법 안과급내분비과주원치료적무안저병변적당뇨병환자급NPDR환자248례248지우안납입연구.소유환자균행광상간단층소묘(OCT)、형광소안저혈관조영(FFA)、안부채색다보륵혈액성상(CDFI)검사.배제중심시망막유명현수종、출혈、삼출적기타안저병변자.OCT측량거황반중심주시점1、1～3、3～6 mm처중심시망막후도,장환자안중심시망막후도분인시망막후도정상、변박、증후조.학정중심시망막후도정상범위위216.4～304.9 μm.중심시망막후도개우216.4～304.9 μm자납입시망막후도정상조,＜216.4 μm자납입시망막후도변박조,＞304.9 μm자납입시망막후도증후조.FFA검사시,관찰병기록비-시망막순배시간、시망막동맥기-정맥기(A-V)형광충영시간.CDFI검사시,검측각조환자안동맥(OA)、시망막중앙동맥(CRA)급첩상후단동맥(PCA)적수축봉치속도(PSV)、박동지수(PI)급조력지수(RI).대비관찰불동시망막후도조안저혈관충영상태급안부혈류동역학지표이동.결과 시망막후도정상、변박、증후조환자적비-시망막순배시간분별위(10.42±0.51)、(10.36±0.64)、(12.94±0.46)s；시망막A-V형광충영시간분별위(9.15±1.36)、(6.36±1.15)、(13.56±2.04)s.시망막후도증후조여시망막후도정상조간(t=1.93,P=0.04)、시망막후도증후조여시망막후도변박조간(t=4.49,P=0.00)비-시망막순배시간비교,차이유통계학의의；시망막후도변박조여시망막후도정상조간(t=2.13,P=0.03)、시망막후도증후조여시망막후도정상조간(t=2.49,P=0.02)、시망막후도증후조여시망막후도변박조간(f=5.38,P=0.00)시망막A-V형광충영시간비교,차이유통계학의의.시망막후도증후조여시망막후도변박조간OA、CRA、PCA적PSV(t=3.290、-5.520、-4.900)、PI(t=-4.310、-5.230、-4.390)、RI(t=4.970、6.160、5.990)비교,차이균유통계학의의(P＜0.05).결론 중심시망막후도대무안저병변적당뇨병환자급NPDR환자안저혈관충영상태유명현영향.
Objective To study the relationship between central retinal thickness and retinal vascular filling state of patients with non-proliferative diabetic retinopathy (NPDR).Methods A total of 248 diabetic patients without retinopathy or with NPDR in the hospital were enrolled in the study.Only the right eye of these patients were examined by optical coherence tomography (OCT),fundus fluorescein angiography (FFA),color Doppler flow imaging (CDFI).Patients with central retinal edema,hemorrhage and exudation were excluded from this study.Central retinal thickness was measured by OCT at the points of 1 mm,1 to 3 mm,and 3 to 6 mm from the fovea.The patients were divided into retinal thickness normal,thinning and thickening groups according to their central retinal thickness.The normal range of central retinal thickness was defined as 216.4-304.9 μm in this study.The arm retinal circulation time and retinal arterial phase and venous phase (A-V) fluorescence filling time were recorded by FFA examination.The peak systolic velocity (PSV),pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA),central retinal artery (CRA) and posterior ciliary artery (PCA) were measured by CDFI examination.The retinal fundus vascular filling state and ocular hemodynamic indexes were compared between different groups.Results The arm retinal circulation time of retinal thickness normal,thinning,thickening groups was (10.42±0.51),(10.36±0.64),(12.94±0.46) seconds respectively; the retinal A-V fluorescence filling time was (9.15±1.36),(6.36±1.15),(13.56±2.04) seconds.The difference of the arm retinal circulation time was statistically significant between the thickening and normal groups (t=1.93,P=0.04),and between the thickening and thinning groups (t=4.49,P=0.00).The retinal A-V fluorescence filling time was statistically significant between the thinning and normal groups (t=2.13,P=0.03),and between the thickening and normal groups (t=2.49,P=0.02),and between the thickening and thinning groups (t=5.38,P=0.00).The difference of PSV (t=3.290,-5.520,-4.900),PI (t=-4.310,-5.230,-4.390) and RI (t=4.970,6.160,5.990) of OA,CRA and PCA was statistically significant between the thickening and thinning groups (P＜0.05).Conclusion Central retinal thickness can affect the retinal vascular filling state of diabetic patients without retinopathy or with NPDR.
